ANNA MIETHKE MORAIS

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PAHC, Hospital das Clínicas, Faculdade de Medicina - Médico
FMUSP, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 23
  • conferenceObject
    Knowledge In Mechanical Ventilation Among Internal Medicine Residents Before And After A Respiratory Icu Rotation
    (2016) AYRES, P. P. M. R.; MIETHKE-MORAIS, A.; COSTA, E. L. V.; CARUSO, P.; BARBAS, C. S. V.; CARVALHO, C. R.; FERREIRA, J. C.
  • conferenceObject
    Differential diagnosis in silicosis and the importance of an accurate occupational history
    (2014) AMARAL, Alexandre Franco; MIETHKE-MORAIS, Anna; PRADO, Gustavo Faibischew; TERRA-FILHO, Mario; SANTOS, Ubiratan de Paula
  • conferenceObject
    Smoking status, prevalence of smoking-related diseases and their impact on costs in patients hospitalized in the thoracic units of a tertiary hospital in Brazil
    (2013) MORAIS, Anna Miethke; LOMBARDI, Elisa Maria Siqueira; PRADO, Gustavo F.; MARTINS, Stella R.; PACELI, Renato; TERRA-FILHO, Mario; SANTOS, Ubiratan de Paula
  • conferenceObject
    Baseline Knowledge Of Mechanical Ventilation Among Incoming Interns Participating In A Boot Camp Training Prior To Starting An Internal Medicine Residency Program In Brazil
    (2016) LIMA, R. B. M.; ZENI, E. M.; LAUTERBACH, G. D. P.; HERBST, L. G.; AYRES, P. P. M. R.; MIETHKE-MORAIS, A.; NUNES, M. P. T.; FERREIRA, J. C.
  • article 2 Citação(ões) na Scopus
    COVID-19: what have we learned?
    (2020) HO, Yeh-Li; MIETHKE-MORAIS, Anna
  • article 0 Citação(ões) na Scopus
    Data-driven, cross-disciplinary collaboration: lessons learned at the largest academic health center in Latin America during the COVID-19 pandemic
    (2024) RITTO, Ana Paula; ARAUJO, Adriana Ladeira de; CARVALHO, Carlos Roberto Ribeiro de; SOUZA, Heraldo Possolo De; FAVARETTO, Patricia Manga e Silva; SABOYA, Vivian Renata Boldrim; GARCIA, Michelle Louvaes; KULIKOWSKI, Leslie Domenici; KALLAS, Esper Georges; PEREIRA, Antonio Jose Rodrigues; COBELLO JUNIOR, Vilson; SILVA, Katia Regina; ABDALLA, Eidi Raquel Franco; SEGURADO, Aluisio Augusto Cotrim; SABINO, Ester Cerdeira; RIBEIRO JUNIOR, Ulysses; FRANCISCO, Rossana Pulcineli Vieira; MIETHKE-MORAIS, Anna; LEVIN, Anna Sara Shafferman; SAWAMURA, Marcio Valente Yamada; FERREIRA, Juliana Carvalho; SILVA, Clovis Artur; MAUAD, Thais; GOUVEIA, Nelson da Cruz; LETAIF, Leila Suemi Harima; BEGO, Marco Antonio; BATTISTELLA, Linamara Rizzo; DUARTE, Alberto Jose da Silva; SEELAENDER, Marilia Cerqueira Leite; MARCHINI, Julio; FORLENZA, Orestes Vicente; ROCHA, Vanderson Geraldo; MENDES-CORREA, Maria Cassia; COSTA, Silvia Figueiredo; CERRI, Giovanni Guido; BONFA, Eloisa Silva Dutra de Oliveira; CHAMMAS, Roger; BARROS FILHO, Tarcisio Eloy Pessoa de; BUSATTO FILHO, Geraldo
    Introduction The COVID-19 pandemic has prompted global research efforts to reduce infection impact, highlighting the potential of cross-disciplinary collaboration to enhance research quality and efficiency.Methods At the FMUSP-HC academic health system, we implemented innovative flow management routines for collecting, organizing and analyzing demographic data, COVID-related data and biological materials from over 4,500 patients with confirmed SARS-CoV-2 infection hospitalized from 2020 to 2022. This strategy was mainly planned in three areas: organizing a database with data from the hospitalizations; setting-up a multidisciplinary taskforce to conduct follow-up assessments after discharge; and organizing a biobank. Additionally, a COVID-19 curated collection was created within the institutional digital library of academic papers to map the research output.Results Over the course of the experience, the possible benefits and challenges of this type of research support approach were identified and discussed, leading to a set of recommended strategies to enhance collaboration within the research institution. Demographic and clinical data from COVID-19 hospitalizations were compiled in a database including adults and a minority of children and adolescents with laboratory confirmed COVID-19, covering 2020-2022, with approximately 350 fields per patient. To date, this database has been used in 16 published studies. Additionally, we assessed 700 adults 6 to 11 months after hospitalization through comprehensive, multidisciplinary in-person evaluations; this database, comprising around 2000 fields per subject, was used in 15 publications. Furthermore, thousands of blood samples collected during the acute phase and follow-up assessments remain stored for future investigations. To date, more than 3,700 aliquots have been used in ongoing research investigating various aspects of COVID-19. Lastly, the mapping of the overall research output revealed that between 2020 and 2022 our academic system produced 1,394 scientific articles on COVID-19.Discussion Research is a crucial component of an effective epidemic response, and the preparation process should include a well-defined plan for organizing and sharing resources. The initiatives described in the present paper were successful in our aim to foster large-scale research in our institution. Although a single model may not be appropriate for all contexts, cross-disciplinary collaboration and open data sharing should make health research systems more efficient to generate the best evidence.
  • article 15 Citação(ões) na Scopus
    Setting up hospital care provision to patients with COVID-19: lessons learnt at a 2400-bed academic tertiary center in SAo Paulo, Brazil
    (2020) PERONDI, Beatriz; MIETHKE-MORAIS, Anna; MONTAL, Amanda C.; HARIMA, Leila; SEGURADO, Aluisio C.
    As of August 30, 2020, Brazil ranked second among countries with the highest number of COVID-19 cases, with the city of SAo Paulo as the national epidemic epicenter. Local public healthcare institutions were challenged to respond to a fast-growing hospital demand, reengineering care provision to optimize clinical outcomes and minimize intra-hospital coronavirus infection. In this paper we describe how the largest public hospital complex in Latin America faced this unprecedented burden, managing severe COVID-19 cases while sustaining specialized care to patients with other conditions. In our strategic plan a 900 bed hospital was exclusively designated for COVID-19 care and continuity of care to those not infected with coronavirus ensured in other inpatient facilities. After 152 days, 4241 patients with severe COVID-19 were hospitalized, 70% of whom have already been discharged, whereas the remaining Institutes of the complex successfully maintained high complexity inpatient and urgent/emergency care to non-COVID-19 patients. (C) 2020 Sociedade Brasileira de Infectologia.
  • article 36 Citação(ões) na Scopus
    COVID-19-related hospital cost-outcome analysis: The impact of clinical and demographic factors
    (2021) MIETHKE-MORAIS, Anna; CASSENOTE, Alex; PIVA, Heloisa; TOKUNAGA, Eric; COBELLO, Vilson; GONCALVES, Fabio Augusto Rodrigues; LOBO, Renata dos Santos; TRINDADE, Evelinda; D'ALBUQUERQUE, Luiz Augusto Carneiro; HADDAD, Luciana
    Introduction: Although patients' clinical conditions have been shown to be associated with coronavirus disease (COVID-19) severity and outcome, their impact on hospital costs are not known. This economic evaluation of COVID-19 admissions aimed to assess direct and fixed hospital costs and describe their particularities in different clinical and demographic conditions and outcomes in the largest public hospital in Latin America, located in Sao Paulo, Brazil, where a whole institute was exclusively dedicated to COVID-19 patients in response to the pandemic. Methods: This is a partial economic evaluation performed from the hospital's perspective and is a prospective, observational cohort study to assess hospitalization costs of suspected and confirmed COVID-19 patients admitted between March 30 and June 30, 2020, to Hospital das Clinicas of the University of Sao Paulo Medical School (HCFMUSP) and followed until discharge, death, or external transfer. Micro- and macro-costing methodologies were used to describe and analyze the total cost associated with each patient's underlying medical conditions, itinerary and outcomes as well as the cost components of different hospital sectors. Results: The average cost of the 3254 admissions (51.7% of which involved intensive care unit stays) was US$12,637.42. The overhead cost was its main component. Sex, age and underlying hypertension (US$14,746.77), diabetes (US$15,002.12), obesity (US$18,941.55), chronic renal failure (US$15,377.84), and rheumatic (US$17,764.61), hematologic (US $15,908.25) and neurologic (US$15,257.95) diseases were associated with higher costs. Age strata >69 years, reverse transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19, comorbidities, use of mechanical ventilation or dialysis, surgery and outcomes remained associated with higher costs. Conclusion: Knowledge of COVID-19 hospital costs can aid in the development of a comprehensive approach for decision-making and planning for future risk management. (C) 2021 Sociedade Brasileira de Infectologia.
  • article 4 Citação(ões) na Scopus
    Epidemiologic Surveillance in an academic hospital during the COVID-19 pandemic in Sao Paulo, Brazil: the key role of epidemiologic engagement in operational processes
    (2020) MARCILIO, Izabel; MIETHKE-MORAIS, Anna; HARIMA, Leila; MONTAL, Amanda C.; PERONDI, Beatriz; AYRES, Jose Ricardo de Carvalho Mesquita; GOUVEIA, Nelson; BONFA, Eloisa; NOVAES, Hillegonda Maria Dutilh
  • article 3 Citação(ões) na Scopus
    Mortality over time among COVID-19 patients hospitalized during the first surge of the pandemic: A large cohort study
    (2022) MARCILIO, Izabel; LAZAR NETO, Felippe; CORTEZ, Andre Lazzeri; MIETHKE-MORAIS, Anna; NOVAES, Hillegonda Maria Dutilh; SOUSA, Heraldo Possolo de; CARVALHO, Carlos Roberto Ribeiro de; LEVIN, Anna Sara Shafferman; FERREIRA, Juliana Carvalho; GOUVEIA, Nelson
    BackgroundCapacity strain negatively impacts patient outcome, and the effects of patient surge are a continuous threat during the COVID-19 pandemic. Evaluating changes in mortality over time enables evidence-based resource planning, thus improving patient outcome. Our aim was to describe baseline risk factors associated with mortality among COVID-19 hospitalized patients and to compare mortality rates over time. MethodsWe conducted a retrospective cohort study in the largest referral hospital for COVID-19 patients in Sao Paulo, Brazil. We investigated risk factors associated with mortality during hospitalization. Independent variables included age group, sex, the Charlson Comorbidity Index, admission period according to the stage of the first wave of the epidemic (early, peak, and late), and intubation. ResultsWe included 2949 consecutive COVID-19 patients. 1895 of them were admitted to the ICU, and 1473 required mechanical ventilation. Median length of stay in the ICU was 10 (IQR 5-17) days. Overall mortality rate was 35%, and the adjusted odds ratios for mortality increased with age, male sex, higher Charlson Comorbidity index, need for mechanical ventilation, and being admitted to the hospital during the wave peak of the epidemic. Being admitted to the hospital during the wave peak was associated with a 33% higher risk of mortality. ConclusionsIn-hospital mortality was independently affected by the epidemic period. The recognition of modifiable operational variables associated with patient outcome highlights the importance of a preparedness plan and institutional protocols that include evidence-based practices and allocation of resources.